![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by Deniseuk190466 on April 24, 2007, at 6:40:16
I'm still depressed on Lexapro, very little motivation, enthusiasm or inclination to talk to anyone and I am still experiencing anxiety.
I realise that I might be deluding myself about ECT, afterall if meds aren't working then why should ECT but I would really like to give it a try. God most normal people would really like to go on a holiday, really like to buy a new car. Here's me with one ambition left and that's to try ECT.
I was wondering if anyone had ECT on this board and were unable to work again afterwards?
At least I am sort of functioning still and I know that work provides some sort of distraction so don't want to jeapardise my chances of working again if I did try it not that my psychiatrist will let me right now.
Thanks..........Denise
Posted by greywolf on April 24, 2007, at 7:33:16
In reply to Has ECT stopped anyone from being able to work?, posted by Deniseuk190466 on April 24, 2007, at 6:40:16
I don't have personal knowledge of that, but I have recently been told by my psychiatrist that I cannot have ECT because the memory impairment would not allow me to do my job.Greywolf
Posted by Phillipa on April 24, 2007, at 9:20:58
In reply to Re: Has ECT stopped anyone from being able to work?, posted by greywolf on April 24, 2007, at 7:33:16
I think some are isn't Blueberry? But a lot of memory loss supposed to come back. Are you considereing this seriously Denise? Love Phillipa
Posted by Deniseuk190466 on April 24, 2007, at 11:29:20
In reply to Re: Has ECT stopped anyone from being able to work?, posted by greywolf on April 24, 2007, at 7:33:16
Hi,
Did they say that you wouldn't be able to do your job period or that you wouldn't be able to do it straight away?
Thanks....Denise
Posted by Deniseuk190466 on April 24, 2007, at 11:38:13
In reply to Re: Has ECT stopped anyone from being able to work?, posted by Phillipa on April 24, 2007, at 9:20:58
Hi Phillipa,
I just want to enjoy life again, I want to care if I live or die again. I know that sounds melodramatic but most of the time during the day the thought that I might just keel over and die sort of appeals to me.
I never used to feel this way about life and the medication used to help years ago, as it did for you. I had a brief period between 2003 and 2005 where the Seroxat (for some inexplicable reason) suddenly started working after a week of being on it and after 2 years of feeling like this. I actually started to enjoy life again and then the medication seemed to stop working.
I don't really enjoy anything, I just get through each day, without planning anything, just sort of going with the flow all the time and it's not a way to live as far as I'm concerned. I can still function but I don't actually feel like I care about myself or take an interest in myself anymore. Choosing what to wear for the day is an effort and yet when I'm well I love clothes and I like to think about what I'm going to wear.
So I want to try anything. I guess I'd be ok about having a poor memory if then at least I felt less depressed/anxious but then people say their memory gets screwed and they are still depressed.
But then when I see that Lcat10 (Karen) is feeling better it makes me want to try it. I can't help but feel "I want some of that".
Denise
Posted by greywolf on April 24, 2007, at 12:04:17
In reply to To Greywolf, posted by Deniseuk190466 on April 24, 2007, at 11:29:20
Denise:
I was told that the memory loss would probably be temporary, but that it would last too long for me to function in my job. The nature of my job would allow me to deal with a day or two of problems (I'd just take off), but nothing longer term.
Instead, VNS has been strongly recommended, but I'm waiting to see studies that show its efficacy.
Greywolf
Posted by Racer on April 24, 2007, at 15:29:55
In reply to Re: To Greywolf » Deniseuk190466, posted by greywolf on April 24, 2007, at 12:04:17
Just another thought... My pdoc has brought that up, as something he's seeing remarkable results from. I don't know about the UK, but it's supposed to be approved over here about now, isn't it?
Denise, I'm sorry you're not doing well. It's so frustrating, and I feel for you. I've been through it myself, and am finally through to the other side. The view is much better from here. I don't know much about ECT, but here's what I do know:
1. Yes, it can work when meds have failed. In fact, it is sometimes said to improve the effectiveness of medications. Sometimes it's given to people with TRD, who then go on to find that medications which did not work in the past now work and keep them in remission.
2. Although I don't know about the memory issues, most everyone I've known who's had it done did so during a period of hospitalization. I think it can also be done OP, but since that doesn't seem to be the norm -- at least the initial treatments, at least around here -- I think that indicates that you might need at least a temporary leave of absence from your job.
I know things are different over there, with the NHS, but honestly -- from what I remember, you haven't come close to exhausting your options for medications. All of the SSRIs have a different flavor, so it's worth trying different drugs to see if another might work better for you than Lexapro is at the moment. Lexapro left me feeling locked inside myself -- I couldn't even talk, it just seemed to much trouble. Zoloft was better, although it may have left me a bit restless. Prozac was the best for me, and continues to be my first choice for SSRIs. Then there are options like Remeron, Wellbutrin (which I think it's available there except as an anti-smoking drug?), Effexor, etc. And there are combinations which help, too. I guess I'd say talk to your doctor, let him know how frustrated and scared you are, how desparate you are becoming, and ask if he'll try to work with you a little bit more to find a solution? It can't hurt, right?
I'm so sorry you're struggling so much, Denise. Ihope things get better soon.
Posted by rvanson on April 24, 2007, at 20:51:24
In reply to Has ECT stopped anyone from being able to work?, posted by Deniseuk190466 on April 24, 2007, at 6:40:16
> I'm still depressed on Lexapro, very little motivation, enthusiasm or inclination to talk to anyone and I am still experiencing anxiety.
>
> I realise that I might be deluding myself about ECT, afterall if meds aren't working then why should ECT but I would really like to give it a try. God most normal people would really like to go on a holiday, really like to buy a new car. Here's me with one ambition left and that's to try ECT.
>
> I was wondering if anyone had ECT on this board and were unable to work again afterwards?
>
> At least I am sort of functioning still and I know that work provides some sort of distraction so don't want to jeapardise my chances of working again if I did try it not that my psychiatrist will let me right now.
>
>
> Thanks..........Denise
Hi Denise,I really would use ECT as a last resort for many reasons. I have suffered from major adhedonic depression, anxiety and crippling social phobia since my early 20's and I have never tried ECT for these reasons, that I have studied for many years in search of a cure:
1. ECT often does work but only for a year or less.
Only in a few cases does it last for a long time without retreatment. Thus it is much like the A/D drugs only worse, since they dont effect long term memory in most cases.
2. With ECT the lack of concentration and forgetfulness of past events rarely goes away completely,leaving you in a disabled state and
possibly unable to work or live a normal life again (I know that you feel *very* unwell right now, so understand that I am giving you this advice with that in mind).Remember, I am nor a medical doctor or a medical professional of any sort, but I have studied many medical and medical historical books on the subject of mental illnesses and I want you to know that up front.
You need help and you need it now, not later, IMO. I am just not convinced that ECT is the way to go, except in the short term.
The only thing I can suggest at this point, assuming that you have tried the usual list of A/D medications is an aytipical medication like a MAOI (Nardil or Parnate),lithium or a pro-dopamine medication of some kind possibly an ampetamine-type medication.
Please let us know how you are doing and write back here, OK?
Posted by Deniseuk190466 on April 25, 2007, at 6:40:32
In reply to What about TMS?, posted by Racer on April 24, 2007, at 15:29:55
Hi Racer,
Thanks for responding. I've tried Remeron and it didn't work for me.
I tried Effexor in about 2002 and I don't think I got up to very high doses but It helped a little but I didn't get a full response from it.
I rTMS in Vancouver that was when I was a lot better than I am now and I didn't feel any beneficial effects from rTMS.
I really don't know what to do next. I've added Zyprexa 2.5mg to the lexapro but it doesn't seem to be helping that much so far.
How long did you try lexapro for and at what dose and how long did it take for Prozac to work for you? What are you taking now?
Thanks....Denise
Posted by Deniseuk190466 on April 25, 2007, at 6:44:27
In reply to Re: Has ECT stopped anyone from being able to work?, posted by rvanson on April 24, 2007, at 20:51:24
Hi,
I tried Nardil and it didn't work for me. The only drug that helped was Seroxat 40mg and that stopped working around Christmas 2005.
I haven't tried stimulants, can they help with anhedonia?
The only thing that seems to help right now is if I take 10mg of Zyprexa and then a couple of days later my mood seems to lift but I have to take it on/off like that which is not an ideal situation.
Antidepressants used to work so well for me years ago and I didn't have any of the problems I have had lately.
Denise
Posted by chiron on April 25, 2007, at 8:21:52
In reply to Re: Has ECT stopped anyone from being able to work?, posted by rvanson on April 24, 2007, at 20:51:24
I've had 2 short ECT series this year and a few in between the 2 series (but not consistently).
My dr. wanted me to take a month off when I decided I wanted to try them because everyone reacts differently. For me, they weren't too bad. On about 4 of the ECTs I've had, I have gone in to work by 10 am the same day (my brother drops me off because I shouldn't be driving).
I've had a couple recently while on Emsam, and it's not been as easy as a recovery. I've had a headache and nausea the rest of the day. I don't know if it is the Emsam, or my body just reacts differently now. So I have to take the day off, but I can go in to work the next day.
I do have a little memory loss, some things start coming back that day, some things I need a little reminder and it comes back. I have never forgotten where I work or how to do my job. There are just a few things from the past that are not clear to me, but I have kept documentation on hand in case I need it.
But of course this is just my experience, and everyone reacts differently. Some don't have any memory loss, some have major loss.
Good luck with your decision.
Posted by Racer on April 25, 2007, at 12:01:10
In reply to Re: What about TMS?, posted by Deniseuk190466 on April 25, 2007, at 6:40:32
> >
> Thanks for responding.Sure. I wish I could help more.
>
> I tried Effexor in about 2002 and I don't think I got up to very high doses but It helped a little but I didn't get a full response from it.It sounds as though trying a higher dose of Effexor might be worthwhile. Has Cymbalta been approved over there yet? It might be a better choice, if it has. If you're getting a partial response, raising the dose makes sense. It could be that raising the dose of Effexor would have brought on the relief you need.
>
> How long did you try lexapro for and at what dose and how long did it take for Prozac to work for you? What are you taking now?
>Let's see, I wasn't on Lexapro very long -- maybe a couple of months? It was NOT a good choice for me. I think I was on 5mg, which did nothing, and when I raised it to 10mg, I just shut down. Depressed, with that tunnel vision you get with depression, and I couldn't even be bothered to speak. Too much trouble, and it felt as though my lips were sealed shut.
Prozac has worked for me in combinations. I don't think I've ever taken it alone. Lemme see, I've taken it with Effexor -- which is a bad combination, from a psychopharm standpoint, but a GP put me on it -- Wellbutrin, and other drugs. Usually, it starts picking up in about two weeks for me, although I get side effects before that. Since I take it in combination, and have had the best luck adding it to another drug, rather than adding another drug to it, I take a very low dose, and it has kicked up my response after a pretty short time.
Right now, I'm taking the following:
Wellbutrin XL 450 mg
Prozac 5 mg (10 mg every other day)
SAMe 200 mg bid
Ritalin 5 to 15 mg, split into two dosesSo far, it's mostly helping me. Anxiety is still a problem for me, but mostly anything that treats the anxiety makes the depression worse. And, anything that is effective against depression for me makes the anxiety worse. More of that cosmic joke, you know?
From what you've described, honestly, I'd say ask your doctor about trying a TCA. I've been told desipramine is great, and it's one I would try again if we weren't trying to have a baby. If it didn't work on its own, maybe adding in a low dose of Prozac or Zoloft would do the trick. I know the NHS isn't as easy to deal with as our system here, but it's still worth asking about. If Paxil worked for you, Lexapro is a good option to try, but it doesn't seem to be helping you. How long have you been on it again? And how high a dose? (Sorry -- speaking of memory loss...)
Good luck, Denise. I really hope you find relief soon.
Posted by rvanson on April 25, 2007, at 18:14:15
In reply to To Rvanson, posted by Deniseuk190466 on April 25, 2007, at 6:44:27
> Hi,
>
> I tried Nardil and it didn't work for me. The only drug that helped was Seroxat 40mg and that stopped working around Christmas 2005.
>
> I haven't tried stimulants, can they help with anhedonia?
>
> The only thing that seems to help right now is if I take 10mg of Zyprexa and then a couple of days later my mood seems to lift but I have to take it on/off like that which is not an ideal situation.
>
> Antidepressants used to work so well for me years ago and I didn't have any of the problems I have had lately.
>Hi Denise,
Yes the stimulants can work for some people, but certainly not all. The new ADHD medications like Strattera can help but can be awful if you have anxiety issues already.
They can be addictive, but no more so then tobacco or alcohol are, and those two are quite deadly if taken for many years, unlike most prescribed medications.
Before AD's were invented the two classes of medications that doctors used for depression were the opoid class meds and ampetamine-type medications.
Many people of my age (52) had parents and grandparents back in the 1930', 40's and 50's who were prescribed Benzedrine for depression,
a stimulant medication that is not used much anymore.When it comes to stimulant meds you may have difficulty in finding a Pdoc that will Rx them for you becuase of all the paperwork and FDA regulations, so if your doc says no, you may have to find a new Pdoc that will help you.
Reboxitine is another medication you might try but its not available in the USA, and Dr. Bob's rules won't allow me to discuss this med much futher as its not FDA approved nor available here.
The one last class of FDA meds that some US doctors prescribe off-label are the dopamine-agonist drugs like Cabergoline (very expensive) and the new Restless Leg Syndrome meds like Mirapex or Requip.
There is a new drug treatment I have read about recently called "Ketamine", but it is injected
and not in a pill form and I dont think its FDA approved for Depression yet.I am sorry to hear about the Nardil not working for you. It often works when nothing else has so far. May I ask what dosage you took and for how long?
Posted by Racer on April 25, 2007, at 18:25:15
In reply to Re: To Denise, posted by rvanson on April 25, 2007, at 18:14:15
> >
> Reboxitine is another medication you might try but its not available in the USA, and Dr. Bob's rules won't allow me to discuss this med much futher as its not FDA approved nor available here.
>We can -- and do -- discuss medications not available in the US. What we can't do is discuss how to obtain those medications, or any others, without a doctor's prescription.
I think Denise is in the UK -- at least, I'm guessing that from her name -- but it is possible to import unapproved drugs under some circumstances. Several people here on this board import tianepine, for instance, which is not available in this country. They do so under their doctor's supervision, and within legal guidelines.
This board is also international, so many people here can get drugs legally available in their country, which might not be available in North America.
That's just a little clarification. Thank you for trying to stay within the guidelines of the site. In this case, you have just a little more room to do so ;-)
Racer, acting as deputy for Dr Bob
Posted by lcat10 on April 25, 2007, at 23:25:39
In reply to Has ECT stopped anyone from being able to work?, posted by Deniseuk190466 on April 24, 2007, at 6:40:16
Denise, I was told to not work during ECT; I was in the hospital from March 1st to March 17th at 2 times per week ECT and outpatient for one week and quit after that week as the cognitive problems were becoming more severe and prolonged. I was off work for six weeks, have since returned, and it is getting better this second week back. However, I will say that what seemed to be a more positive benefit is not so great now. I think I said I was at 90%. Well now I would say I am at around 60%. I would think long and hard about any decision to do ECT. This is not something to take lightly. One never knows how one will react. I happen to have more cognitive side effects than was anticipated by my pdoc and ECT doc, and my decision to stop was something they both agreed was the right thing to do. Some of the cognitive side effects have improved, and some have not. I also seem to have developed a seizure disorder since the ECT. Be careful of what you wish for.
lcat10
Posted by Sebastian on April 26, 2007, at 11:54:00
In reply to Has ECT stopped anyone from being able to work?, posted by Deniseuk190466 on April 24, 2007, at 6:40:16
I was not able to work for a while after ECT, but when I did make it back to work, it took a while to get back up to speed. Yes can work fine now.
Posted by deniseuk190466 on April 26, 2007, at 13:05:27
In reply to Re: Has ECT stopped anyone from being able to work?, posted by Sebastian on April 26, 2007, at 11:54:00
Sebastian,
Did it help with your depression, what kind of depression do you suffer from (sorry if Ive already asked you this) and did you have unilateral or bilateral ECT?
Denise
Posted by deniseuk190466 on April 26, 2007, at 13:11:01
In reply to Re: To Denise, posted by rvanson on April 25, 2007, at 18:14:15
Hi,
Thanks for your suggestions. I'm currently functioning but still don't feel as though I'm enjoying anything or looking forward to anything.
I think I took the full recommended dose of Nardil on all three occasions) I can't remember the dose for sure. I know I checked the recommended dose out on the internet the last time and just took it. The last time It wasn't recommended by my Doctor, I was desperate, wasn't taking anything, had a bottle of pills left from the time before and just decided to start taking it. It seemed to help with the anxiety but not with the depression and when I stopped taking it I felt very suicidal.
Denise
Posted by rvanson on April 26, 2007, at 14:30:06
In reply to Re: To rvanson, posted by deniseuk190466 on April 26, 2007, at 13:11:01
> Hi,
>
> Thanks for your suggestions. I'm currently functioning but still don't feel as though I'm enjoying anything or looking forward to anything.
>
> I think I took the full recommended dose of Nardil on all three occasions) I can't remember the dose for sure. I know I checked the recommended dose out on the internet the last time and just took it. The last time It wasn't recommended by my Doctor, I was desperate, wasn't taking anything, had a bottle of pills left from the time before and just decided to start taking it. It seemed to help with the anxiety but not with the depression and when I stopped taking it I felt very suicidal.
>
>
> DeniseWell, the usual working dose for the "old" Nardil was 45 to 90 mg, with some taking even higher doses, but since the remformulation of Nardil in 2005, I understand it takes more of the medicine to be effective.
To be honest in my studies of the type of depression you seem to have, with adhedonia as a major component, a serotogenic medication like an SSRI, is usually not usually a good choice.
If you do live in the UK, as was suggested here, Reboxitine is an approved medication with the NHS there and I would suggest that as the next medication to try, to get a handle on this particular condition.
It's a very stimulating norepineprine reuptake medication with mild dopamine effects, so it might do the trick and since it isn't a controlled or addictive medication, and it should be fairly easy to obtain from a
doctor there.BTW, have you tried the A/D medication, Wellbutrin (Bupropion), as of yet?
Its also a good medication to try for adhedonic depressive symptoms, and it could be the ticket out of that hellish adhedonia, as well.
Posted by Sebastian on April 26, 2007, at 19:09:10
In reply to Re: To Sebastian, posted by deniseuk190466 on April 26, 2007, at 13:05:27
At the time I was very psychotic. I don't know what kind it was, but it deffinitly had a strong impact on my mental issues and functioning. Not sure if I was depressed or not, didn't realy think about it then. Just did what I had to. Which ment I was locked in hospital against will and forced to take all kinds of medicin and lots of ECT. By the end of the ECT, my brain was erased, and I felt like they were programing it. It was like living in alter realitly, where everything was not comprehendable, strang thoughts like they are putting crack in my ciggarettes, everything was a joke, and so real, didn't know what anything was. My perception of realitly was very warped. Couldn't tell if ECT was making me better or worse, actualy it took me a while to realize what it was they were doing to me, my memory was being erased. And still is to this day very foggy at that time.
I don't think ECT is something you need. I would only use it as last resort.
Posted by sisss42 on April 26, 2007, at 22:03:26
In reply to Re: Has ECT stopped anyone from being able to work?, posted by Sebastian on April 26, 2007, at 11:54:00
Of course it is your decision, and everyone has different reactions to it. I have had ECT in the past, Before ECT I was so incapicated that I could not get out of bed to do anything, could not eat, think, sleep, etc, all the sypmtoms that go with being severely depressed and was at total rock bottom, work would have been impossible.
ECT saved my life, however it came at a cost, memory loss was and still is an issue. I now have lost the mental capacity to study and continue with my Uni Degree.
I would only consider ECT necessary if I ever get as severely depressed as in the past.
Of course the decision is yours please think very carefully before you decide.Best Wishes from OZ
sis
Posted by Deniseuk190466 on April 27, 2007, at 10:17:03
In reply to Re: To rvanson, posted by rvanson on April 26, 2007, at 14:30:06
Hi again,
I honestly believe that Serotonin drugs are the drugs for me even though they aren't working well at the moment as they have worked well for me in the past. Seroxat when I was in my 20s and again (not so well) at the age of 37.
I have tried Cymbalta (which is supposed to work on norepinephrine and Effexor and neither worked for me.
I believe that my depression encompasses everything really, lack of motivation, lack of pleasure in anything, lack of looking forward, not wanting to really engage with anyone, anxiety. Etc Etc. I am functioning but that's about it.
I did try Wellbutrin for about a week and it didn't seem to do anything.
For some reason the SSRIs which used to work aren't working and I don't know why and neither do the experts. I suppose because they don't really know how they work to start with.
I will think about Reboxetine though, thanks for suggesting it, I'm not read that encouraging results on it though.
Denise
Posted by Deniseuk190466 on April 27, 2007, at 10:18:46
In reply to Re: To Sebastian, posted by Sebastian on April 26, 2007, at 19:09:10
Thanks for responding Sebastian, sounds like you've been through a really bad time.
Are you working or doing anything now?
Denise
Posted by Deniseuk190466 on April 27, 2007, at 10:22:09
In reply to Re: Has ECT stopped anyone from being able to work?, posted by sisss42 on April 26, 2007, at 22:03:26
Hi,
Thanks for taking the time to respond and I'm really sorry that you are unable to complete your degree. Are you still depressed now?
What do you plan to do with yourself now you can't complete your degree or do you think you might be able to go back to it at some point in the future?
Denise
Posted by sisss42 on April 27, 2007, at 11:48:54
In reply to To Sisss42, posted by Deniseuk190466 on April 27, 2007, at 10:22:09
> Hi,
>
> Thanks for taking the time to respond and I'm really sorry that you are unable to complete your degree. Are you still depressed now?
>
> What do you plan to do with yourself now you can't complete your degree or do you think you might be able to go back to it at some point in the future?
>
>
>
> DeniseHi Denise
I am midly depressed, My pdoc says my depression is treatment resistant, we have recently added Remeron to my mix of Effexor and Diazapam in the hope that it will augment the Effexor dose 225mg was up to 450mg at one stage but it raised my blood pressure and had to be reduced.
I doubt whether I will be able to return to my studies in the future, I am an artist and all I hope for at this stage is to be able to return to my painting but motivation and energy levels are low so we are hoping the Remeron (Avanza) here in OZ) will give me a bit of a boost. I am making no plans for the future and for now am taking things one day at a time.
Best wishes from OZ
sai
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.